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BACK TO BASICS PEDIATRICS, S CORP
NPI 1205310356
Pediatrics in Algonquin, IL

Active since September 24, 2018CLIA 14D2156257 · Waiver
2403 HARNISH DR STE 101, ALGONQUIN, IL 60102(224) 520-0087 Get Directions Write a Review

NPPES record last updated: December 12, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 12, 2018, Sep 24, 2018 (2 updates tracked since 2018).

About Back To Basics Pediatrics, S Corp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BACK TO BASICS PEDIATRICS, S CORP (NPI 1205310356) is a healthcare organization registered as a pediatrics in Algonquin, Illinois and active in the NPI registry since September 2018. The organization holds a CLIA Waiver certificate valid through October 11, 2026 and lists Christine Poulos, Pediatrician, as its authorized official.

NPPES Registry Identity

NPI1205310356
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameBACK TO BASICS PEDIATRICS SC
Location Address2403 HARNISH DR STE 101Algonquin, IL 60102-6803
Mailing Address2403 Harnish Dr Ste 101Algonquin, IL 60102-6803 · (224) 333-0730 · Fax (224) 333-0748
Phone(224) 520-0087
Organization SubpartNo
Authorized OfficialChristine PoulosPediatrician · (224) 520-0087
Enumeration DateSeptember 24, 2018
Last NPPES UpdateDecember 12, 20182 updates tracked since enumeration
✔ NPI 1205310356 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
2403 HARNISH DR STE 101, Algonquin, IL 60102
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Other Names 1

Other NameBack To Basics Pediatrics, S Corp

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2156257

Back To Basics Pediatrics, S C · Algonquin, IL
Active · expires Oct 11, 2026
CLIA Number14D2156257
Laboratory TypePhysician Office
Certificate Effective DateOctober 12, 2024
Certificate Expiration DateOctober 11, 2026
Laboratory DirectorChristine M. Poulos M D
Laboratory Phone(224) 333-0730
Laboratory LocationBack To Basics Pediatrics, S C2403 Harnish Dr - Ste 101, Algonquin, IL 60102
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHRISTINE M POULOS MD
Pediatrics
2403 HARNISH DR STE 101
ALGONQUIN, IL 60102
McHenry County (224) 333-0730
ROCIO VARGAS CPNP-PC
Nurse Practitioner (Pediatrics)
2403 HARNISH DR STE 101
ALGONQUIN, IL 60102
McHenry County (224) 333-0730
JOYCE ELUGBADEBO MD
Pediatrics
2403 HARNISH DR STE 101
ALGONQUIN, IL 60102
McHenry County (224) 333-0730

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Back To Basics Pediatrics Sc's NPI number?

The NPI number for Back To Basics Pediatrics Sc is 1205310356. It was assigned to this organization in the NPPES registry on September 24, 2018. The provider is also known as Back To Basics Pediatrics, S Corp.

Where is Back To Basics Pediatrics Sc located?

Back To Basics Pediatrics Sc is located at 2403 Harnish Dr Ste 101, Algonquin, IL 60102. The listed phone number is (224) 520-0087.

What is Back To Basics Pediatrics Sc's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Back To Basics Pediatrics Sc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2156257) is associated with this NPI, valid through October 11, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Back To Basics Pediatrics Sc was last updated on December 12, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.